May 1, 2026

Postpartum Psychosis Awareness Day: Educating Mothers, Families, and Health Care Providers

Postpartum Psychiatric Disorders, Postpartum Psychosis

Postpartum psychosis is the most severe form of postpartum psychiatric illness. What are the signs and symptoms?

MGH Center for Women's Mental Health

Today, May 1, 2026 is Postpartum Psychosis Awareness Day, launched by survivors of postpartum psychosis in 2021 to raise awareness about the most severe and devastating of perinatal mental health disorders. This is an opportunity to support mothers and families who have experienced postpartum psychosis, to increase awareness of postpartum psychosis, and to provide education to mothers, families, and health care providers.

For women who are struggling with perinatal mood and anxiety disorders, emergency support can be found here:

Postpartum Support International HelpLine: 1-800-944-4773

Maternal Mental Health Hotline: 1-833-9-HELP4MOMS (via text or phone)

Content warning: This article contains information on perinatal psychiatric disorders, including mentions of self-harm, suicide, and child maltreatment.

What Does Postpartum Psychosis Look Like?

About 15% of women suffer from some type of postpartum mood or anxiety disorder. Postpartum psychosis occurs in about 1 out of every 1000 childbirths. Because many women with PP psychosis have suicidal thoughts or behaviors that may compromise their ability to care for their baby, PP psychosis is a psychiatric emergency that requires immediate attention.

Risk Factors: While some women have no history of psychiatric illness, about 50-75% of women with postpartum psychosis have a history of bipolar disorder, or less commonly schizoaffective disorder or schizophrenia. Many women who have postpartum psychosis have a family history of postpartum psychosis or bipolar disorder.

Onset: Postpartum psychosis usually emerges quite rapidly over the course of a few days, representing a dramatic change in mood and behavior. Typically postpartum psychosis begins within the first two weeks after childbirth; occasionally women present with psychotic symptoms after the first postpartum month.

Symptoms: Women with postpartum psychosis present with a range of symptoms that are most consistent with a mixed or manic episode as seen in individuals with bipolar disorder. There is, however, no “classic” presentation; some women may have very apparent symptoms, while others may have more subtle and less visible symptoms. In addition, It may also be difficult to recognize postpartum psychosis because the symptoms may have a waxing and waning or transitory quality. The full range of symptoms may not be obvious at a single time point or at the time of evaluation. Thus, it is important to consider, as part of a thorough evaluation, the impressions and observations of others – family, other health care providers — who are able to give a more longitudinal view of the illness.

Mood symptoms may precede the onset of psychotic symptoms. Women may present with mixed symptoms, including rapid fluctuations in mood, irritability, agitation, or severe anxiety. Less commonly, women present with hypomanic or manic symptoms: feeling overly elated and energetic, talking excitedly and rapidly, needing less sleep or inability to sleep, grandiosity or feeling that one has special qualities or abilities.

Sleep disruption: Most women with PP psychosis report the inability to fall asleep and stay asleep. Severe, persistent sleep problems may further complicate a woman’s ability to function and care for her infant.

Psychotic symptoms refer to delusions (false beliefs), hallucinations (hearing voices or having visions), and unusual, erratic, or disorganized behavior.

Delusional thoughts: Women with postpartum psychosis may have delusions of persecution and may believe somebody is trying to harm them or their baby, or they may believe that their baby is evil or gravely ill or not their baby at all. Women may have grandiose delusions about their baby’s abilities or their own powers. Delusions are sometimes religious in nature; many women with PP psychosis may believe that they are acting in accordance with God’s wishes. These delusional beliefs are not based in reality and may place the mother and her baby at risk, if the mother’s actions are guided by these delusional thoughts.

Paranoia, guardedness: Women with postpartum psychosis often have delusional thoughts that somebody is trying to hurt them or their baby. Thus, they may be suspicious of others, including family members, and may not openly express these fears. They may not allow others to care for the baby. They may not accept food or medicine from others because they may believe somebody is trying to control or poison them.

Ideas of reference: Women with PP psychosis may feel that certain events, objects, or experiences have a special and personal meaning. They may believe that a particular event or object is a sign, symbol, or message specifically meant for them. They may misinterpret casual events as having a personal significance, or they may feel that the media, for example, news reports or songs, is speaking directly to them. These messages may inform their behavior.

Hallucinations: Women with postpartum psychosis may experience a variety of hallucinations. These can include auditory hallucinations, such as hearing other people’s voices or talking or sounds that aren’t actually present, or visual hallucinations, where they see things that aren’t there. Some women may experience command auditory hallucinations, which instruct them to harm themselves or their baby. Less commonly, women with postpartum psychosis may also experience olfactory or tactile hallucinations.

Agitation: Increased energy, restlessness, pacing, inability to sit still.

Erratic or disorganized behavior or speech: Psychotic symptoms may interfere with a woman’s ability to process information correctly, and this may result in strange or uncharacteristic behaviors. Speech may seem illogical or irrational. Women with PP psychosis sometimes appear to be confused or perplexed. This may affect their ability to appropriately feed and care for the baby. In this setting, a woman may not be able to respond appropriately to the baby’s cues and may have impaired judgment that compromises her ability to care for the baby.

Suicidal thoughts appear to be relatively common among women with PP psychosis, and women with PP psychosis are at high risk for suicide.

Thoughts of harming the baby: Women with PP psychosis may have thoughts of harming or killing their child. These thoughts reflect their delusional beliefs. Some mothers commit this act because they believe that the baby is gravely ill and the mother does not want the baby to suffer. Harm to the baby may occur when the mother is receiving messages from God or others that instruct her to kill her baby. It is important to note that these acts are extremely rare and that the vast majority of women who experience postpartum psychosis do not harm themselves or their children.

Suicidal Thoughts During the Postpartum Period

Suicidal thoughts may vary in intensity. A mother who is depressed may report passive suicidal ideation, stating that she wishes she were dead or thinks she would be better off dead, but she is not actively thinking about taking her own life. Less commonly, a woman may report active suicidal ideation and may be thinking about specific plans or methods to end her life. Suicidal thoughts are often accompanied by feelings of worthlessness and uselessness and the belief that the baby would be better off without their mother.

Suicidal ideation is especially concerning when it occurs within the context of postpartum psychosis. Because psychotic symptoms distort one’s perceptions and beliefs and interfere with one’s ability to make rational decisions, women with PP psychosis are at high risk for suicide.

Even when a woman reports that she has no desire or intention of acting on these suicidal thoughts, she should be evaluated by a medical professional. Suicidal ideation is never a normal event and must be viewed as a symptom of psychiatric illness.

Postpartum Psychosis is a Psychiatric Emergency

If it is suspected that a mother has postpartum psychosis, she should be evaluated by a medical professional emergently. Because rates of suicide and infanticide are high in this population, we generally recommend close observation and psychiatric hospitalization of women with PP psychosis.

For women who are struggling with perinatal mood and anxiety disorders, emergency support can be found here:

Postpartum Support International HelpLine: 1-800-944-4773

Maternal Mental Health Hotline: 1-833-9-HELP4MOMS (via text or phone)

The outcome described with respect to Lindsay Clancy is exceedingly rare. However, the tragedy has provided a springboard for discussion of postpartum psychiatric disorders, including the severe illness postpartum psychosis. Postpartum mood and anxiety disorders are common but are exquisitely treatable.